HomeMy WebLinkAboutBLD1989-00080V T._
13U.ING O'CRfIT APPLICATION) 0 „_
Jefferson County Building Dep artmentoP'.O . E3'ox 12200Port Townsend. WA 98368
LOCATION 1
SPECIFIC LOCATION SITE ADDRESS /D ,sce„-t- �.
POSTAL DISTRICT C_ /SUBDIVISION / L,
LEGAL DESCRIPTION LOT 62 0 BLOCK /-y DIVISION , , TAX NUMBER
PARCEL NU CN�''�"/1i/ `- ill ,1 / 4 SECTION
PLANNING AREA SECTION TOWNSI-11 P'{9., , NORTH RANGE_) WM
BUILDING INFORMATION
B,�ILDING TYPE TYPE OF IMPROVEMENT SQUARE FOOTAGE /
: INGLE FAMILY `W BUILDING MAIN FLOOR rtlr�
❑ M'"'ODILE HOME !!!❑ ADDITION 2ND FLOOR
❑ MODULAR HOME ❑ ALTERATION BASEMENT
❑ DETACHED/ATTACHED 0 REPAIR CARPORT `
GARAGE ❑ REPLACEMENT GARAGE C)
❑ WOODSTOVE ❑ WRECKING/DEMOLITION COMMERCIAL
❑ MULTI - FAMILY D RELOCATION/MOVING INDUSTRIAL
NUMBER OF UNITS
MOBILE HOMES A �y��
❑ COMMERCIAL ' SIZE tr' $35 6
❑ INDUSTRIAL
YEAR �] `� $ 1 6 _
❑ HOTEL/MOTEL/DORMITORY MAKE._ .,1� = ---A 10 $8 !(pa
NUMBER OF UNITS
❑ OTHER - SPECIFY ESTIM D COST OF S 1 $8
IMP OVEMEIJTS IT7,19.7,- 7?yRKET VALUE
UBC OCCUPANCY GRO $
SELECTED CHARACTE ISTICS OF BUILDING
PRINCIPLE TYPE OF FRAME PRINCIPLE TYPE OF HEATING FUEL
4 WOOD FRAME •ELECTRICITY 0 COLLECTIVE SOLAR
❑ MANUFACTURED 0 WOODSTOVE 0 PASSIVE SOLAR
❑ STRUCTURAL STEEL 0 GAS 0 COAL " 1
❑ REINFORCED CONCRETE 0 OIL OTHER - SPECIFY) fIlft
❑ MASONRY ( WALL BEARING ) DIMENSIONS
❑ OTHER - NUMBER OF STORIES I TOTAL LAND AREA
DEPARTMENTAL REVIEW
HEALTH DEPARTMENT T PE OF SEWAGE DISPOSAL NUMBER OF PROPOSED BEDROOMS
i PUBLIC OR PRIVATE NUMBER OF EXISTING BEDROOMS
0 INDIVIDUAL ( SEPTIC ) NUMBER OF PROPOSED BATHROOM -
APPROVED DATE
0 INDIVIDUAL WELL NUMBER OF EX 1 ST I PIG BATHROOM
PUD TYPE OF WATER SUPPLY
0 PUBLIC ( NAME OF WATER SUPPLY)
APPROVED DATE PRIVATE ( NAME OF WATER SUPPLY / 1-- •
PLANNING DEPT . WITHIN SHORELINE JURISDICTION
0 YES NAME OF ADJACENT WATER BODY
0 ( °----
❑ NO •
APPROVED DATE BANK HEIGHT SETBACK
PUBLIC WORKS DEPT ROAD RIGHT-OF -WAY WIDTH
01125 NAME OF PUBLIC ROAD
NAME OF PRIVATE ROAD
APPROVED DATE ROAD ACCESS FE7MIT REQUIRED ❑ YES ❑ NO
IDENTIFICATION
m_M _
NAME ,�!M//,p, I I NG ADDRESS // ZIP ,eyT/EL NO
OWNER v" �,/+�(} t -/--11�Y La, o %/Le::[...-t Pk�^ .._,...--.� 7 ey6J... /
a
y
yNT P_ T'A`t E L 1 C I"F1.. � (-��G,.�. 3 . 9�f
ARCH
THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS;
S NATURE ,OF APPLICANT
0-0— -- A9 y( / C TE / ER CHECK NU-INIBER OR CASH
:7&:.1
ED. BY M I�T]CFEES
.,d
A� „< 7/' . ) BASE FEE I NSPECT ION
1 .1989_., /i 9/ BLDG SURCHARGE PLAN CHECK
JEFFEOs
PLANNovt'$B�OUN IS.VL ENERGY SURCHARGE I TOTAL
iD/ c"l-) 8 1 1 NUMBER REFUND DATE DATW 1?SSJ
BUILDING OFFICIAL g!/J��r �
.iFFTPF.R: C)N C C)tJ1\rT"P RIYT T.i)T T' C iRF: F T 1T i'
Jefferson County Planning and Su i i d i ng Department
Courthouse, 3rd F inor
PO Sox 1220
Port Townsend, WA 9836R
2O6-38 -y 1 41
PRRM'I T # -ST.f59-OORO DATE. TSSTTFT). : c)q I 1 3 i RSq
STTF. Auurc N.:.,n : t5 TOPSATT� TAN ,
:PORT T.UDLOW. WA 9S365
cOWNr.R J T M ST N(;RR / PHONR : 437-2845
MAT T.TNC AT)TTR c i 'T n .r.?3`''
!PORT T,TiDJLOW WA 98355
CONTRACTOR . . :NO CONTRACTOR' PHONE :
MAILING ADDR :
•
CONTR . iC #: F.XP T RAT T ON fAT7
PARCF.T, NO. . . : 9qO 7OO-Oeso
T.F.c;A L i1F.SC. . : STR 09-28-O i F.wMi; TAX # 1
LOT nO RT,i1C'K' , PORT LunLoW #3
DESCRIPTION OF IMPROVEMENT: single family residence
) Footing/Setbacks (Shoreline Sethack) %Mnh i i e Home Blocking:
f ) Foundation :
) Underground PiumhinnrUnderground insulation
) rFraming/Piumhinn/Chimney-
) Tnsuiatinn •
( ) Sheetrnc !
i Sewage Disposal System Final :
i Fina 'Cccmnancv Approval :
CALL 385-9 1 4 1 24 HOURS T N ADVANCF TO SC FDUT,F, I NSPFCT T ONS .
Office Hours 9 a .m. to 5 p.m.
inspector ' s Hours 9 - 10 a .m.
24 Hour Recorder for Inspections.